OurFuture.org Blogs: Tom Sullivan

Why Johnny Can’t Reason

Tom Sullivan — Sun, 28 Feb 2010 18:11:04 -0800

A recent dip into conservative drive-time talk radio raised Michael Shermer's question: Why do smart people believe weird things?

It’s not as if the conservative talk audience is all Mensa members. (Sean Hannity, at least, need not apply.) And it’s not as if the left doesn’t believe its share of nonsense. It’s that conservative “experts” with educational pedigrees and elite-sounding, non-elitist titles spout ideas they expect listeners to accept without question.

Like how replacing employer-based health insurance with health savings accounts means a $10,000 raise for the average family.

The day of the president’s health care summit, the Cato Institute’s Director of Health Policy Studies, Michael Cannon, spoke with WBT Charlotte’s Tara Servatius. No surprise, neither had anything good to say about the Democrats’ health care reform proposals. Neither showered praise on health insurers, of course. They know which way the wind blows. Instead, Cato’s Cannon recommended more and bigger health savings accounts. [timestamp 34:22]

Cannon: That $10,000 that employers use to buy coverage for average, for the worker with average family coverage. That $10,000 doesn’t come out of the employers’ profits. That comes from workers’ wages. His salary would be $10,000 higher if he weren’t getting health benefits at work, and he’d be able to use that money to pick, to purchase coverage that meets his needs – and it stays with him from job to job – that’s more secure and provides higher-quality coverage ...”

Plus freedom and all that. The employer-based system takes financial decisions out of people’s hands, Cannon said. He recommended that “we give that money back to the American people” and allow market forces to control costs.

Read: Relieve companies of paying employees’ health care costs and the average American family gets a $10,000 raise – a libertarian “peace dividend.” Johnnys all around Charlotte nodded at their radios. So did their local radio host.

Servatius: You know what’s fascinating about that, Michael Cannon, if I had been allowed to do that for my, at the last two employers I had ... Let’s just say, had it been a real option where say I could write that $10,000 off and lower my tax, you know, my total taxable income… If I had done that going back, you know, seven years when I wasn’t having children and I was single and, you know, maybe went to see a doctor once a year, maybe. I could have paid for the births of both my children in cash. Chosen my doctor. Been able to shop by prices. Would have had it in the savings account and really would have been able to do it competitively. And would have still had a ton of money left over, in cash, to pay for my health care.

And if pigs could fly, we could train them to bomb the Taliban.

Cato isn't quite that naive. Still, it is on A.M. talk peddling the idea that eliminating employer health plans would mean a boon for employees, not windfall profits for employers. Freedom-loving employees who wish to manage their own health care could drop out of their employers' group health plans. Employers would simply roll over $10,000 into employees’ health savings accounts. Next up, Cato will sell you some swampland in Florida.

Maybe these smart people – experts – don’t really believe their own nonsense. They just expect us to. They expect working families getting by on $40,000 a year to save $10,000 a year. They expect sleep-deprived workers stretched thin from juggling jobs, kids, shopping, church, home and car repairs, bills, etc., to take a graduate course in America’s labyrinthine health care system and to comparison shop for medical procedures when little Johnny gets sick. Or else endeavor to persevere.

Experts like these spend their time fretting about economic efficiency and market “distortions.” They would hand business another windfall and expect workers to pay for it with an unfunded mandate – of time. Workers who can’t handle it? Well, that’s what natural selection – like applesauce – is for.

Current health savings accounts are okay, Cannon believes, except they’re too small. They leave employers still controlling too much of workers’ health care dollars.

Cannon: So what we need to do is wrest from the employers the money that they use to purchase our health insurance so that workers control that money. Workers can save it in a large health savings account, and then use that money to purchase insurance that meets their needs.

Wresting money from employers to benefit workers? If a liberal said anything remotely like that, the torches and pitchforks brigade would be in the streets calling for his Marxist head on a platter. Thank goodness it was said in that happy place called conservative talk radio where the credulous come for their daily dose of alternate reality.

No wonder Johnny can’t reason.

The War On Terror: A Cage Of Our Own Making

Tom Sullivan — Mon, 11 Jan 2010 01:32:33 -0800

America’s fight against terrorism is a stooge scene. Washington meets every new attack not by addressing the motives behind Islamist violence, but by adding another layer of security to infringe on Americans’ privacy and dignity.

In the old Three Stooges short, “A Plumbing We Will Go,” Curly tries to stop the water spraying out of a bathroom wall by threading on some pipe fittings. The water just sprays out the end. So he threads on more. And more. And more. But the water keeps spraying from the end of each new piece. Curly eventually discovers that he’s imprisoned himself in a cage of pipe, with water still spraying out of the last piece he added.

So, terrorists armed with box cutters bring down three airliners on September 11, 2001. Washington’s response? Institute a massive domestic electronic surveillance program. Gut habeas corpus. No nail clippers in carry-on. Make passengers empty their pockets and raise their arms for a sweep with a handheld metal detector.

Richard Reid makes it through airport security in Paris with explosives in his shoes. Washington’s response? Make passengers stand in line and take off their shoes.

Police in England disrupt a plot to blow up transatlantic flights using liquid explosives. Washington’s response? No skin cream, toothpaste, shampoo over 3 oz. in your carry-ons; have them ready in a zip-lock bag for inspection. Deposit anything larger in the trash bins, please.

Umar Farouk Abdulmutallab goes through airport security in Lagos, Nigeria. He goes through security again in Amsterdam. He then tries to bring down an airliner over Detroit using a bomb hidden in his underwear. Washington’s response? Colonoscopies for passengers boarding in Cleveland.

Okay, full body scans. Backscatter X-rays. Whatever. Thread on another stick of pipe. Overlay another level of “security.” But whatever you do, don’t address the motives behind the violence.

At a White House press briefing last week, reporter Helen Thomas asked and asked again why these terrorists “want to do us harm.” White House Counterterrorism and Homeland Security advisor, John Brennan, gave Thomas a response right out of the Bush administration playbook, “Al Qaida is an organization that is dedicated to murder and wanton slaughter of innocents.” Not exactly post-Pearl Harbor "slant-eyed japs" rhetoric, but not far off either.

Glenn Greenwald went all reductio ad absurdum on that response:

Brennan's answer -- they do this because they're Evil and murderous -- is on the same condescending cartoon level as the "They-Hate-us-For-Our-Freedom" tripe we endured for the last eight years. Apparently, if Brennan is to be believed, Islamic radicals, in their motive-free quest to slaughter, write down the names of all the countries in the world and put them in a hat and then stick their hand in and select the one they will attack, and the U.S. just keeps getting unlucky and having its name randomly chosen. Countries like China, Brazil, Japan, Chile, Greece, South Africa, France and a whole slew of others must have really good luck. That Al Qaeda is evil and murderous and perverts Islam is a judgment about what they do, not an answer as to what motivates them.

Osama bin Laden himself gave a few clues in his February 1998 fatwa, Greenwald notes. Why do they attack us? Because we have our infidel "crusader armies" on the Arabian peninsula and in Saudi Arabia, home to Islam’s holiest sites. Because of the destruction wrought on Iraq and Iraqi children by economic sanctions. Because of U.S. support for Israel – because of Gaza, and Sabra and Shatila. Post-September 11, add the occupation of Iraq and Afghanistan, uncounted civilian deaths, and torture, prisoner abuse and killings at American-run prisons, Abu Ghraib, Guantanamo, and Bagram.

For the executive branch, giving Thomas’ question the answer it deserves is a no-win proposition. To discuss why Islamist terrorists preferentially target the United States means examining those events. It might require a serious examination of U.S. foreign policy in the Middle East and maybe changes to it. Dealing with that head-on risks providing al Qaida’s murderers with a thin veneer of legitimacy. The media, the GOP and the American right wing would have a field day.

It's easier just to thread on more pipe until we find ourselves prisoners in a cage of our own making.

Obama Just Ran Out Of Slack

Tom Sullivan — Wed, 16 Dec 2009 21:41:21 -0800

The media was quick to declare the Obama honeymoon over this summer. Yet supporters exhilarated by Barack Obama’s stunning win in November 2008 were still willing to cut him a lot of slack. That slack just ran out.

The simplest, most comprehensive health insurance reform –- single payer –- was off the table before the legislative effort started, replaced with an amorphous "public option." David Sirota and others called it a violation of Negotiating 101: compromise comes at the end of the process, not at the beginning. Now the campaign to enact substantive health care reform has foundered on Sen. Joe Lieberman (I-CT). And on Obama’s refusal to bust heads. White House Chief of Staff Rahm Emanuel instructed Sen. Harry Reid (D-NV) to cut a deal with Lieberman for his vote, even if it meant jettisoning Medicare expansion and a public option –- along with cost controls, lifetime benefit caps and drug re-importation. Reid did. So much for the Chicago-style politics Fox News warned about.

All year, progressive reform advocates tried to remain calm as the House and Senate bills got watered down. “Don’t freak out,” they told each other. At every stage, they were told "trust us" as the bills got weaker and weaker. They can expect to hear that once again as the House and Senate bills go to conference. An Organizing for America rumor in September had it that the White House was working secretly on its own bill to spring in mid October once opponents had spent themselves pushing back against the House and Senate versions.

That, obviously, never surfaced. It was more wishful thinking from Obama supporters trying to keep the faith while stuffing down the nagging feeling that they were being sold out and that there never was any hope of seeing a bill with a public option. At Salon, Glenn Greenwald argues that that was the plan all along and that, quoting Sen. Russ Feingold (D-WI), "This bill appears to be legislation that the president wanted in the first place." White House spokesman Robert Gibbs criticized Howard Dean on Wednesday for trying to kill the Senate bill, Greenwald observes. Why did the White House go after a former governor, yet never call out sitting senators Blanche Lincoln, Ben Nelson and Joe Lieberman for their obstruction?

Matt Taibbi’s headline-grabbing takedown of Goldman Sachs, “Inside The Great American Bubble Machine” in Rolling Stone in July, detailed the extent to which Goldman Sachs and other Wall Street investment banks brought about the Great Recession. Many Goldman veterans on the Obama economic team, Taibbi warned, were charged with repairing the damage to which they themselves had contributed. Still, Obama’s base told themselves the boss had it under control.

But Taibbi’s expose this month, “Obama’s Big Sellout” delivered the coup de grâce to any remaining credibility the White House had as agents of financial reform. Immediately after the election, the economists who helped craft the campaign’s populist economic message were sent to bureaucratic “Siberia.” Taibbi listed a roster of Rubinites (as in former Clinton Treasury secretary, Bob Rubin) and Citigroup bankers whose “balanced budgets, free trade and financial deregulation” philosophy is behind the administration’s economic policy. The financial reform bill passed in the House reflects the same tepid regulatory impulses, as does the Senate’s health care proposal. The Federal Reserve will be audited, but “cram-down” and the effort to reinstate Glass-Steagall both failed. Public Citizen declared, “The bill does very little to address industry structure ... The biggest banks are now bigger than they were before the crisis.” Even as Democrats celebrated the passage of financial reform in the House, Obama’s state-level organizers braced for fallout from the Taibbi article among supporters .

Obama’s base had also expected a radical break from Bush-era policies deployed in prosecuting the “war on terror.” But no court has yet ruled on the legality of treatment former prisoners allege constituted torture. The Obama Justice Department “has worked tirelessly to shutter or pre-empt torture litigation,” lawsuits brought by former detainees who allege they were tortured while in U.S. custody under Bush, says Slate’s Dahlia Lithwick. “To be clear,” Lithwick writes, “it's not that torture victims are losing these trials. They can't even find their way into a courtroom. And, time after time, it's the Obama administration barring the door.” In a conference call with reporters, Jameel Jaffer, head of the ACLU's National Security Project, noted that while "the Bush administration constructed a legal framework for torture, the Obama administration is constructing a legal framework for impunity."

Some Obama supporters have begun reacting to his fundraising e-mails with skepticism bordering on disgust. Their patience has worn as thin as promises that "we will not back down" on health care reform. On December 16, after the White House had caved to Joe Lieberman's demands on the Senate health care bill, caller after caller to progressive talk radio programs expressed outrage. An NBC/Wall Street Journal poll showed that 47 percent consider his health care plan a bad idea, and only 32 percent favor it. NBC's Chuck Todd wrote on Twitter: "Most of the movement on the 'bad idea' comes from some of the president's core support groups, folks upset about lost public option." Radio host and author Thom Hartmann suggested, “Put this healthcare bill where the sun don’t shine.” Blogger Josh Marshall at Talking Points Memo filed a post entitled “Goodbye, Cruel World!” to respond to the flood of e-mails TPM had received from angry progressives seeking “'walk me back from the ledge' services.” An open letter to the president posted on Daily Kos from a self-described “former Obamabot” expressed deep regret at having “been bamboozled, hoodwinked. Sold a shiny bill of goods.”

Obama had best start listening. Of all people, he should know that one of the worst things you can do with campaign volunteers is waste their precious time. Because they won't come back.

Nothing Personal: The Triumph of Corporate Thinking

Tom Sullivan — Sun, 06 Dec 2009 23:46:17 -0800

"They screwed me over,” Mike said.

We were at one of those seminars where professionals earn a couple of continuing education hours over a long lunch. I hadn’t seen Mike in a few years and asked if he was still at the same company. Not since April, he said. After well over a decade the company had cut him loose. (The company laid me off in 2002.)

Mike used “they” to describe the corporation that discarded him, as if the executives who laid him off had betrayed him. As if he would have made a different decision in their position. As if there was some “they” there. As if any corporation actually shares his core values.

It is easy to anthropomorphize modern corporations. We experience them through our colleagues, through conversations around the coffee pot or the lunch table. Yet like clockwork, we express surprise when corporations behave towards employees in a fashion that seems decidedly inhuman. In fact, they never were human. Employees simply reinforce that illusion.

Rolling Stone’s Matt Taibbi had the quote of the year with his description of Goldman Sachs as “a great vampire squid wrapped around the face of humanity.” The image recalls the Alien parasite that uses humans as incubators and then discards their carcasses once they’ve been used to perpetuate its species. Like that parasite, the modern corporation operates at the level of appetite and instinct. Its habits reflect the cold-blooded logic of self-preservation, of the bottom line, of the Christmas layoff, of the hit man. Business is business. It's nothing personal.

Conceived in law and born on paper, the modern corporation was designed for one purpose: to relentlessly pursue profit for owners while minimizing their liability for its actions. Ironically, "personal responsibility" moralists seem to be the corporate form's staunchest defenders. That Americans who trumpet family values accept such a model for doing business as if it were divinely inspired is a testament to the seductive effectiveness of the design, the same design that brought world financial markets to the brink of collapse just last year.

Now, Americans who witnessed Washington’s bailout of Wall Street have seen just how much the creation has become the master. The regulatory capture of the government is nearly complete. Standing before the U.S. Capitol in the trailer for Michael Moore’s Capitalism: A Love Story, Ohio Democrat Rep. Marcy Kaptur admits, “The people here really aren't in charge. Wall Street is in charge.”

Congressional Oversight Panel Chair Elizabeth Warren writes, “Families understand with crystalline clarity that the rules they have played by are not the same rules that govern Wall Street. They understand that no American family is 'too big to fail.' They recognize that business models have shifted and that big banks are pulling out all the stops to squeeze families and boost revenues.” The middle class is getting squeezed even tighter as Wall Street prospers.

Lab rats with electrodes implanted into their pleasure centers will keep pressing a lever that fires the electrode – ignoring food and water – until they die from exhaustion. But the financial bailout taught J.P. Morgan Chase, Goldman Sachs, Citigroup, Bank of America and other firms that they can keep on pressing the levers that produce their profits and bonuses and, if anyone dies from exhaustion, it will be the American middle class. The Washington Post's Dana Milbank satirized Wall Street’s self-serving efforts to keep Washington from passing any serious reforms, “Don't regulate us now because the economy is still suffering from the mess we made because we weren't regulated the last time. Chutzpah, it appears, is recession-proof.”

The mortgage crisis tied to the derivatives market set into high relief the tension between the values with which most Americans were raised and the bottom-line thinking they learn to live by forty or more hours a week. Staying true to oneself is hard enough in the face of intense social and economic pressure to replace those values with corporate ones. Harder still when facing an adversary that practices asymmetrical warfare. Perhaps the clearest evidence of that is a recent article by University of Arizona law school professor, Brent T. White.

In Underwater and Not Walking Away: Shame, Fear and the Social Management of the Housing Crisis, White wonders why more homeowners are not walking away from mortgages where they owe more than their homes are worth. The numbers say they should. So why don’t they?

Homeowners are operating on an emotional level, White suggests, weighing their financial interests against issues of guilt and self-respect:

... fear, shame, and guilt are not mere “transaction costs” that homeowners calculate according to their own personal tolerance for each. Rather, these emotional constraints are actively cultivated by the government, the financial industry, and other social control agents in order to induce individual homeowners to act in ways that are against their own self interest, but which are - wrongly this article contends - argued to be socially beneficial.

Consciously or not, these “control agents” use people's own sense of decency, plus fear, guilt and shame to encourage consumer “conformity to the norm of meeting one’s mortgage obligations as long as one can afford to do so.”

Lenders, White argues, exploit an “asymmetry of norms” to extract as much from homeowners as possible. He writes, “[T]he asymmetry of moral norms for borrowers and market norms for lenders gives lenders an unfair advantage in negotiations related to the enforcement of contractual rights and obligations...” His recommendation for homeowners is to tune out their emotions when making financial decisions, to plan carefully, and then to walk away from their mortgages when continuing to pay makes no financial sense. The market bust is "a market failure – not a moral failure on the part of American homeowners."

Kenneth Harvey summarizes White’s argument in the Los Angeles Times, “Don't feel guilty about it. Don't think you're doing something morally wrong.” Put another way, stop thinking like a moral actor. Stop thinking as you were taught at home and at church. Compartmentalize. Think bottom line, like a corporation. And if it makes financial sense, screw your creditors. It's nothing personal.

There may be no other good option. That solution has a certain emotional appeal. Rough justice. Stick it to The Man. Fight fire with fire. But fighting an amoral adversary by adopting his values or surrendering one's own, for human beings, at least, carries risks corporate actuaries cannot calculate in a spreadsheet. (The abyss gazes also into you, as Nietsczhe observed.) Giving in to that cold-blooded logic, even if "financially prudent," feels like surrender, and perhaps the final triumph of corporate thinking.

Obama White House Seeks Delay On Declassification

Tom Sullivan — Sun, 29 Nov 2009 22:21:11 -0800

Secret agencies like their secrets secret. Even old secrets. The Boston Globe reported Sunday that “roadblocks” and “turf battles” among government agencies will likely delay the release of millions of pages of documents scheduled to be declassified on December 31. Some date back to World War II.

In spite of President Obama’s pledge to bring new openness to government, the executive order drafted to replace one signed by President Bush in 2003 “is meeting resistance from key national security and intelligence officials, delaying its approval.” To head off the deadline, the new draft order may have to modify the “automatic declassification” provisions of a Bush Executive Order:

Section 3.3(e)(3) By notification to the Director of the Information Security Oversight Office, before the records are subject to automatic declassification, an agency head or senior agency official designated under section 5.4 of this order may delay automatic declassification for up to 3 years for classified records that have been referred or transferred to that agency by another agency less than 3 years before automatic declassification would otherwise be required.

When is “automatic declassification” not automatic? When agency officials can drag their feet indefinitely. To meet the looming deadline, the Federation of American Scientists’ Secrecy News reports, “several agencies would have to forgo a review of the affected historical records, which they are unwilling to do. And so it seems they will simply be excused from compliance.”

According to the Boston Globe:

“They never want to give up their authority,” said Meredith Fuchs, general counsel at the National Security Archive, a research center at George Washington University that collects and publishes declassified information. “The national security bureaucracy is deeply entrenched and is not willing to give up some of the protections they feel they need for their documents.”

Our documents, they need to be reminded. The Globe concludes by acknowledging that even declassification does not render a document public:

Officials estimate that there are 400 million pages of historical documents that have been declassified but remain in government records centers and have not been processed at the National Archives, where the public can view them.

One such document is the official crash report on the B-29 that crashed during a test flight near Waycross, GA in 1948. Writing for the New Jersey Post-Courier in 2003, Matt Katz laid out the details fifty-five years later. The crash killed nine, including three civilian contractors from RCA. The contractors’ widows tried in vain to find out what happened in their husbands’ last moments. After the widows filed a lawsuit charging negligence, the government quashed the case by declaring the official crash report a state secret. United States v. Reynolds (1952) was the landmark case that formally recognized the state secrets privilege.

Only by accident did the daughter of one contractor come across the Air Force accident report – declassified in 2000 – for sale on the Internet. An engine had caught fire. The plane broke apart in mid-air. But there was more, Katz writes: “Failure to follow procedure. Failure to carry out special safety orders. Pilot error. These were the causes identified by the Air Force – all evidence that could have been used 50 years ago to support the claims of negligence.”

There was more:

• Two Air Force orders calling for changes in the exhaust system – "for the purpose of eliminating a definite fire hazard" – were not complied with. The fire began in the exhaust system.

• An Air Force order requiring the inspection of rivets was ignored. Loose rivets may have been a factor in the crash.

• The plane needed "more than the normal amount of maintenance." It had been out of commission because of technical problems 97 of the 189 days before the crash.

The victims’ families in this case only had to wait half a century for their answers from the military. Now, after extensions by presidents Bill Clinton and George W. Bush, America’s secret agencies will get yet another extension from the Obama administration “of an undetermined length - possibly years,” according to the Globe report.

Change deferred. Is it change denied?

Which Public Is That?

Tom Sullivan — Thu, 05 Nov 2009 21:05:50 -0800

The Beltway cognoscenti keep telling us that a bipartisan solution to health care reform is what the public wants. Just what public is it that's more interested in process than results?

Conventional wisdom says that Obama has failed to make Washington more bipartisan if Democrats ram through a health reform bill without Republican support. That would be the Republican support that House Republican whip Rep. Eric Cantor just swore Democrats will never get. “[N]ot one Republican will vote for this bill," Cantor told a “tea party” crowd on Thursday.

Republican strategist Mike Murphy from Thursday’s Morning Edition (NPR):

… I think the great mistake of the Obama presidency, the thing that has taken his numbers among the critical independents who put him in office from very high to low now, is they were elected as a bipartisan problem solver, almost a post-partisan politician. But from the day they've been in, they got a little drunk on the power and they've governed as a one-party liberal party. It's been more of the Democratic dogma, particularly in the House under Pelosi.

And while they have the pure political power to force some things through with their majorities, the Democrats, in my view, are governing too far to the left. They're losing the middle of the country.

Put aside for a moment the up-is-downisms. The public is disillusioned because, as Murphy suggests, Democrats aren’t being bipartisan enough? Or is it really because they have accomplished too little in trying to placate an avowedly obstructionist opposition party?

Observe the coverage of the off-year elections. It is the end of the honeymoon, says Murphy. The media made it out to be a turning point for the White House -- picking up two House seats is, of course, bad news for the Democrats. It's a wonder television news didn't brand the coverage with a catchy name and trademarked graphics.

This should give health care reformers in Congress pause, suggest our media mavens. Why?

Suspense, drama, conflict and histrionics are the stuff of good TV. One would think the media would be egging on Democrats to use the reconciliation process to pass health care reform – with a public option. Think of the ratings. You ain't seen nothin' yet.

See Rep. John Boehner crying on the House floor, streaking his bronzer! Hear Congresswoman Michele Bachmann declare President Obama the antichrist on the steps of the Capitol! Experience the riveting oratory of Joe the Bummer! Watch conservatives in Congress rend their garments as tea partiers fling themselves onto a pyre of burning Constitutions!

Now that’s must-see TV. So why is our “liberal” media suggesting that that would be the worst that could happen? For whom, exactly? It is because the corporate titans behind mass media have a vested interest in seeing health reform fail?

There are more questions than answers.

What public is it that would rather have a bad bipartisan bill rather than a more robust single-party one? The public that's disenchanted because health reform has not been passed already? The majority of Americans that consistent polling shows want a bill with a public option? The people already suffering under a failed and costly health care system? The pragmatic average Joes who go to see Larry the Cable Guy shout "Git ‘Er Done!" from the stage?

That public is more interested in process than results?

Lucky or Good?

Tom Sullivan — Mon, 02 Nov 2009 07:06:05 -0800

The congressman’s staffer said her goodbyes and left the service desk. The cashier, pleasant-looking and about fifty, had listened to the health care conversation from behind the counter. Now that it was just the two of them, she opened up to my wife.

It has been a bad three years. She had been healthy, she said, until she developed a blood disorder. After the diagnosis, her health insurance was cancelled.

There has been a string of cancers diagnosed in her family – six or seven – including her father. The stress on the family is severe. Her mother had a stroke.

But she is lucky – blessed she said – to have this new job. And in this economy, she’s right. The health benefits are especially good. The women’s clothing company is a big supporter of the Susan G. Komen for the Cure movement to fight breast cancer.

Lucky for her again. Since taking the job, she has been diagnosed with breast cancer. Fortunately, her employer is supportive.

Because what with her mother’s stroke, she didn’t want to stress her parents further. She avoided telling them about her breast cancer until she began radiation treatments recently.

They say it’s better to be lucky than good. That is employer-based health care in America. The lucky get treatment until they are too sick to work and their employer has to let them go. Business is business.

It is a good thing the cashier likes her new job. She had better not lose it – for any reason. She’ll lose her insurance too.

Wide-eyed, it had never occurred to her that she could call her congressman or senators and tell them her story, that they might actually listen. My wife urged her to visit or call, and soon.

Because very soon, all of America will find out if they’re listening and if we're lucky.

The Public Necessity

Tom Sullivan — Mon, 26 Oct 2009 00:55:37 -0700

The health care debate – with its leaks, mixed signals and close-to-the-vest dealing – has reform supporters losing their cool while Obama, infuriatingly, maintains his. The uncertainty has strained the tenuous loyalties of a fickle American left. How much talk about "triggers" is real, how much is process, and how much is rope-a-dope?

David Dayen defines the problem for Firedoglake:

Is the White House “insisting” on triggers to take the heat off of Harry Reid, who is having trouble finding the last votes for cloture? Are they drawing fire away from Senate moderates? Are they doing it to keep Snowe thinking the White House is on her side? Do they want to pull a switcheroo in conference committee? Do they actually think that the public option will need some time to get right, so a trigger might help to aid that delay? Are these the words of one rogue faction in the White House that can’t stand the public option and the “left of the left”?

Reports about Thursday night’s White House meeting between Senate Majority Leader Harry Reid and President Barack Obama suggest that Obama is not prepared to twist the arms of remaining Senate holdouts to secure a bill with a public option (sans “triggers”), even though that goal now seems within reach:

"Everybody knows we're close enough that these guys could be rolled. They just don't want to do it because it makes the politics harder," said a senior Democratic source, saying that Obama is worried about the political fate of Blue Dogs and conservative Senate Democrats if the bill isn't seen as bipartisan. "These last couple folks, they could get them if Obama leaned on them."

Meanwhile, Obama's Organizing for America (OFA) found its legs on October 20th, generating 315,000 phone calls to Capitol Hill in support of health care reform. While the approved script called for supporting the “the President’s plan for health reform” – whatever that is – many OFA volunteers support a “robust public option.” OFA’s back channel exhortations for supporters to increase the pressure and “win this thing” tell a very different story from the media narrative about a reluctant, unengaged president.

After eight years of Bush-Cheney, the left was primed for the change Obama promised – and thoroughly distrustful of Washington politics, even his. The mixed signals have Obama’s base clinging to the hope that their leader is playing rope-a-dope with opponents, while other progressives are already declaring Obama a conservative.

If it makes them dig in and fight harder, fine.

But Thomas P.M. Barnett's warning to the Pentagon is one to which progressives should pay heed: "we field a first-half team in a league that keeps score until the end of the game." Progressives have to maintain focus and momentum if they hope to punch through the insurance industry’s goal-line defense. “Allies” in Congress won’t manage that on their own. One year after November 2008, will voters again rise to the occasion or remain on the sidelines with an “Obama hangover”?

A society accustomed to sitting on the couch and being passively entertained is one more accustomed to being governed rather than to governing. Once the vote-counting is over, many citizens tune out again until the next election. A colleague echoing the familiar FDR “make me do it” anecdote, noted that few realize just how hard it is for even their favorite leaders to change things themselves without being pushed hard by supporters.

Anna Quindlen argues in Newsweek that the founding fathers engineered our system to resist radical changes of direction, that Obama is a process-oriented centrist more than the populist firebrand progressives thought they were electing, and that health reform therefore may be more incremental than sweeping.

Perhaps. But that very system did not inhibit the Bush administration from taking the country in a radical direction overnight, nor did it stop a population alarmed by those radicals from firing them overnight. Obama didn’t do that. We did.

Quindlen concludes by reminding readers that if Americans want change, they had best not sit back and expect someone else to do it for them, because

“... if the American people want the president to be more like the Barack Obama they elected, maybe they should start acting more like the voters who elected him, who forcibly and undeniably moved the political establishment to where it didn't want to go.”

OFA got a taste again of what that's like on October 20th. If the rest of America really believes that the health reform it needs is not just a public option, but a public necessity, more Americans will have to get up off the couch and go get it. Neither Obama nor the Democrats will deliver it to their doorstep like a pizza.

What Civilized Country Operates Like This?

Tom Sullivan — Tue, 13 Oct 2009 02:42:18 -0700

You have seen it. The plastic bucket beside the cash register at the convenience store. A photo is taped to it. A child needs an operation. His father lost his job. The family lost its insurance. They are about to lose their home. Can you spare some change?

What civilized country operates like this? In case God-and-country defenders of the status quo need reminding, America’s for-profit health insurance system serves neither.

Reform advocates must hammer away at this relentlessly: health insurance reform is a moral issue more than an economic one.

Nicholas Kristof delivered further proof that the system is morally bankrupt in the October 4 New York Times.

Travis and Michael Waddington hoped to donate a kidney to their father, David, 58, a wine retailer and victim of polycystic kidney disease. PKD had destroyed David’s kidneys. Since the disease is genetic, Travis and Michael needed to be tested for the disease themselves before donating. Yet a positive result might mean the sons might never be able to get insurance. So their doctors advised against getting tested. Another advised getting tested under fictitious names. To protect their sons, husband and wife shot down the idea, even at the risk of David’s life.

Eventually, David received a kidney from a deceased donor, but Michael recently began experiencing PKD symptoms and now faces an insurance nightmare now all too familiar, obtaining affordable insurance – or any insurance – after being diagnosed with a serious illness.

Closer to home, an acquaintance recently donated a kidney to his father under somewhat different circumstances, but with similar risks. Such acts of mercy by organ donors (talk about risky behavior) present insurers with an elective pre-existing condition, and present donors with a moral dilemma. Fortunately, his father’s insurance covered both transplant surgeries. But both the son’s own physician and the transplant surgeons recommended that he say nothing to his insurer. It was illegal to deny coverage or insurance to organ donors, doctors told him. Nonetheless, they often heard of it happening.

Why tempt fate? He told his insurer nothing.

Kristoff calls an insurance system that forces patients into such impossible choices, “the disgrace of the industrialized world.”

But that’s putting it mildly. As T.R. Reid puts it in The Healing of America, our system is virtually a worldwide laughingstock. One thing on which experts at international health care symposia can agree, Reid explains, is that the U.S. for-profit insurance system is a mess. “Bashing the U.S. system is a standard agenda item.”

Joanne Ford, a patient on Social Security disability and wearing Coke-bottle eyeglasses, arrived for a Remote Area Medical free clinic in Knoxville. She came hoping to get a new pair for free. But nearly last in line, she almost missed her chance. Interviewed by 60 Minutes, Ford said tearfully, “I am sad that we are the wealthiest nation in the world and we don’t take care of our own.”

Even the socialist bogeymen of Europe treat their own better.

For-profit insurance can be cruel and capricious, not unlike the age of Dickens that Keith Olbermann invoked in a recent hour-long commentary. America’s uninsured have "a 40 percent higher risk of death than their privately insured counterparts," a new Harvard study finds. Furthermore, 45,000 Americans a year die from lack of health insurance. Like Dickens’ London, America’s working poor too often are either invisible or else blamed as surplus population –– impediments to the economic fortunes of their “betters.”

It is a seasonal tradition to revisit cherished redemption stories during the coming dark nights around the solstice, to refresh human connections not just to family and friends, but to our fellow men. Defenders of the status quo, especially, need to refresh theirs.

America would do well to revisit those redemption stories earlier this year as it considers how best to rehabilitate a business more informed by Wall Street than A Christmas Carol. For-profit health insurance is rare in the civilized world, and rightly so. It is a cold-hearted business more interested in serving the numbers on its balance sheets than the humanity behind the numbers.

That calls into question the humanity of its defenders, like the conservative radio icon who brags about taking on all comers with half his brain tied behind his back. That would be the feeling half. The human half. The half that Messrs. Scrooge and Potter let atrophy as an impediment to being good men of business.

Right now, a popular caterer downtown has posters on her door. A child needs an operation. A strawberry blonde boy in an adult-sized straw hat. He has a severe immune deficiency disease. He is with his parents at Duke University Medical Center for a bone marrow transplant. There's a pancake breakfast to raise money.

You might as well hold a bake sale to buy a bomber.

What civilized country operates like this?

If You Like Medical Bills, You’ll Love These

Tom Sullivan — Mon, 21 Sep 2009 01:28:43 -0700

Activists in the blogosphere are studying well over 500 amendments to Sen. Max Baucus’ Senate Finance Committee health care reform bill, including three “public option” amendments. All sides will hotly debate, soundly trash, and amend the hell out of the Baucus bill, H.R.3200 (on the House side) and any others that come out of the woodwork by October.

But those aren’t the only kind of bills Americans should be worrying about.

My sister died at 37 from a metastatic sarcoma (the same cancer that took Ted Kennedy, Jr.’s leg). I watched her die, went to her funeral, and then went back to her apartment to sift through stacks of medical bills.

In exhaustion and grief, we couldn’t tell which bills were paid, which were not, which were rejected, which were under review, and which were still in the pipeline and wouldn’t arrive for weeks or months. This doesn’t happen in most industrialized countries and shouldn’t happen here. It's a disgrace, a disgrace that none of the bills pending in Congress will cure. A disgrace that health insurance conglomerates and their allies in Congress are fighting hard (and spending hard) to preserve, along with the profits the billing process helps generate.

Over 60 percent of personal bankruptcies in the U.S. are from medical bills. Over three-quarters of those are in families who had health insurance, were probably satisfied with it, and thought their coverage was adequate until a serious illness proved otherwise. But it's the burdensome billing process itself that the health care reform debate has not addressed.

At the America’s Future Now! conference in June, Dr. Salomeh Keyhani of Mt. Sinai Hospital detailed the number of weeks doctors, nurses and their staffs spend each year dealing with insurance paperwork and procedures. Insurers make it as difficult as possible for customers to collect. Bottom line: if patients and doctors get frustrated and go away, the insurer won’t have to pay. Keyhani described the labyrinthine claims process as “passive aggressive” by design.

Keyhani's name came up again last week in connection with a nationwide poll published in the New England Journal of Medicine. Keyhani helped conduct the survey funded by the Robert Wood Johnson Foundation of 5,000 physicians representing a spectrum of specialties and regions, including American Medical Association members. The survey, Keyhani told NPR, found that "nearly three-quarters of physicians supported some form of a public option, either alone or in combination with private insurance options." That included AMA members, whose organization opposes a public option.

Yet only a single-payer-style plan promises to eliminate the mountains of bureaucratic paperwork that make our patchwork system cost nearly twice what other advanced countries pay. But since a nationwide single-payer system is off the table, even if a strong public option gets to the president's desk, most Americans will be sifting through confusing stacks of insurance paperwork for years to come. Some reform.

The anti-reform forces had their Tea Party in Washington on September 12. They offered no alternatives and screamed loudly about not being heard, but not loudly enough to drown out a majority that decides to speak with one voice.

President Obama must know that he has only to say the word and a sea of pro-reform supporters will travel to Washington in support of real reform and a robust public option. If summoned, supporters should bring their collections of medical bills, rejection letters and appeal forms and wave them overhead.

Talk about “Don’t Tread On Me.” Medical insurance paperwork is universally recognized and universally loathed. It could serve as a potent symbol of everything wrong with America’s dysfunctional, for-profit health insurance system.

Reform supporters might, en masse, flood congressional fax machines with their medical bills. Or stage media events with fax machines set up in public spaces for patients to fax their medical bills to Congress -- just to put an exclamation point on demands for meaningful reform.

There's something viscerally satisfying about feeding documents into a fax machine and knowing they're spitting out onto the floor of your congresscritter’s office. It's the next best thing to being there.